Previous studies have suggested that a variety of environmental, including in utero, exposures may affect the early development of asthma. We are currently funded for a trial to examine the effects of a peer education program designed to assess and modify the home environment of Head Start families in the West Town/Humboldt Park communities in Chicago. The purpose of the current study is to extent this program to pregnant women at risk for having asthmatic children in the same community areas. The project will build from a collaborative group already established and committed to ameliorating the course of asthma in the city of Chicago. A total of 350 pregnant women at risk for having asthmatic children will be recruited from Erie Family Health Center, Centro San Bonifacio, Emerson House, and Family Focus Nuestra Familia during the first trimester of their pregnancies over a one and a half year period. They will work with our study nurses and peer educators on assessment and modification of environmental exposures which affect the development and course of asthma, including exposure to in utero and passive smoke, pets, molds, cockroaches, and dust mites. Primary endpoints of the study will be incidence of wheezing and diagnosed asthma in the first year of life. Secondary endpoints will be birth weight of the children, percent of mothers who quit or reduce their smoking, IgE levels at one year of age, percent with positive skin tests at age one and a half years and levels of cat, cockroach, alternaria and mite antigens in the home. In addition, funds for the study will be used to strengthen our educational programs within the public and parochial schools, to increase our work with the local media, and to develop parental support groups.